Effectiveness of a bipolar vessel sealant device for ovariohysterectomy in cats with pyometra

Comparison of the efficacy and perioperative pain between vessel sealing and suture ligation for median celiotomy in canine ovariohysterectomy

Background and Aim: Vessel sealing (VS) is used widely in human medicine and veterinary practice during laparoscopic surgery; however, few studies have investigated VS in canine ovariohysterectomy (OHE) using the median celiotomy approach. This study aimed to compare the effect of VS and suture ligation (SL) on surgical time, blood loss, and perioperative pain in canine OHE through median celiotomy. Materials and Methods: Twenty-eight dogs were randomly and equally assigned into two groups that underwent surgery either by SL at both the ovarian pedicle and uterus or using a disposable VS device. The short form of the Glasgow composite pain scale (SF-GCPS) and the Colorado state university canine acute pain scale (CSU-CAP) were used to determine pain pre-operatively (baseline); at 30 min; and at 1, 2, 3, 4, 24, and 72 h post-operatively. Perioperative physiological parameters, surgical duration, and percentage of blood loss were recorded. Repeated measures analysis was performed to determine the differences in all parameters among time-related tasks and between both groups. A significant difference was defined at p < 0.05. Results: The duration from identification of the first ovary to uterus removal was shorter in VS than in SL (p < 0.05). No clinically relevant differences were found among physiological variables. Both groups showed higher SF-GCPS and CSU-CAP values after surgery compared with baseline. The SF-GCPS in SL at 1 h was higher than in VS (p < 0.05). Two dogs in the SL group required additional post-operative rescue analgesia. No differences were found between the groups in terms of blood loss. Conclusion: The use of a VS device in dogs undergoing OHE celiotomy decreased post-operative pain and shortened the perioperative time, making it an effective alternative technique for this common surgery. However, the VS device must be applied 2–3 times in the same location during the OHE procedure to prevent technical failure. This disposable device was reused up to 5 times for economic reasons without device failure. Soft tissue damage during OHE using the VS device should be investigated in a future prospective study.

Comparison of Two Radiofrequency Vessel-Sealing Device for Laparoscopic Ovariectomy in African Lionesses (Panthera Leo)

Simple Summary

This study evaluated two vessel-sealing devices for dissecting ovaries in adult obese African lionesses undergoing laparoscopic ovariectomy. We evaluated the surgery time the intra- and postoperative complications. The results of our study confirmed the significant advantages of employing the Caiman 12 vessel-sealing device in comparison with the LigaSure Atlas in terms of the time needed to complete ovariectomy, although both instruments could be considered safe. The use of the Caiman 12 is recommended when performing laparoscopic ovariectomies in adults with obesity.

Abstract

To evaluate two vessel-sealing devices with different jaw lengths for dissecting ovaries in adult obese African lionesses undergoing laparoscopic ovariectomy. Twelve lionesses (n = 12) were recruited. The surgical procedures were performed through three portals, with a retractor platform positioned at the umbilical port and cannulas placed 3–4 cm cranial and caudal to the device at the level of the midline. Ovariectomy was performed using a vessel-sealing device according to a randomization list. We evaluated the surgery time the intra- and postoperative complications. The total surgery time was 49.3 min (range 40–61 min) in the Atlas group and significantly lower in the Caiman group (mean 31.8 min, range 26–51 min). The installation phase was similar between the groups. The ovariectomy time was significantly lower in the Caiman group (mean 7.8 min, range 4–11 min) than in the Atlas group (mean 20 min, range 16–30 min). Controlled bleeding was observed at the tip of the uterine horn in two cases in the Atlas group. No other complications were noted. The results of our study confirmed the significant advantages of employing the Caiman 12 vessel-sealing device in comparison with the LigaSure Atlas in terms of the time needed to complete ovariectomy, although both instruments could be considered safe. The use of the Caiman 12 is recommended when performing laparoscopic ovariectomies in adults with obesity.

Pyometra management in the private practice setting

Current management practices of pyometra in the private practice setting are not well documented. The goal of this study was to understand pyometra management in the private practice setting, and the current relationship private practices have with high quality, high volume, spay-neuter (HQHVSN) clinics regarding referral for pyometra surgery. An anonymous electronic survey was piloted and distributed using SurveyMonkey via email, social media, and the Independent Veterinary Practitioners Association targeting veterinarians who see companion animals. A total of 153 responses were received from June-July 2021, with respondents distributed throughout the United States. Practices performed a median of 10 spay and neuters per week, with the median spay cost being $350 (IQR 250-500) for dogs and $250 (IQR 180-350) for cats. The median cost of a pyometra surgery was $1000 (IQR 700-1500) for dogs and $750 (IQR 450-1000) for cats. All practices treated pyometra at least sometimes, despite the disruption (major 19%, moderate 47%, mild 29%, none 5%) to their day. All pyometra presentations were accepted for treatment at least sometimes: BAR/QAR (98%), depressed or non-ambulatory (88%), and obtunded or lateral (62%) with mean estimated survival of 96%, 74%, and 31%, respectively. The majority (56%) of clients were reported to sometimes have trouble paying for all recommended services, while it was less often reported that clients often (31%) or rarely (13%) had trouble. Private practices willing to refer only did so always 20% of the time and sometimes 36% of the time. Private practices will do what they can to treat most pyometras that present at their practice within a timely manner before referring elsewhere. There is currently inconsistent utilization of HQHVSN clinics as a potential referral resource due to location or appointment availability.

Use of a Bipolar Vessel-Sealing Device for Splenic Parenchymal Resection in Three Dogs and One Cat

Based on splenic abnormalities noted during surgery, four client-owned animals (three dogs, one cat) undergoing exploratory laparotomy were identified as candidates for partial splenectomy. In three cases, small mass lesions of the spleen were identified on elective exploratory laparotomy. In one case, the patient was referred for emergency surgery for diaphragmatic hernia with entrapment of stomach and spleen. The discovery of avulsion of a significant portion of the splenic mesentery led to the decision to perform partial splenectomy in this case. All animals included in the study underwent partial splenectomy by one of two board-certified veterinary surgeons at a multispecialty hospital between 2014 and 2018. The same type of bipolar vessel-sealing device was used in each surgery, and three of four partial splenectomy cases recovered uneventfully. One patient went into cardiopulmonary arrest hours after surgery and died; however, this is not suspected to be due to the described partial splenectomy technique. The bipolar vessel-sealing device is suitable for use in resection of the splenic parenchyma in some canine and feline patients. This technique is designed to decrease surgical time, provide effective hemostasis, and preserve the important functions of the spleen that are lost when total splenectomy is undertaken.